Healthcare Provider Details

I. General information

NPI: 1104360130
Provider Name (Legal Business Name): RHOME FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2016
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 NORTH HIGHWAY 287 SUITE B
RHOME TX
76078
US

IV. Provider business mailing address

105 NORTH HIGHWAY 287 SUITE B
RHOME TX
76078
US

V. Phone/Fax

Practice location:
  • Phone: 682-225-3196
  • Fax:
Mailing address:
  • Phone: 682-225-3196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22229
License Number StateTX

VIII. Authorized Official

Name: DR. YOUSSEF SAAD
Title or Position: OWNER
Credential: DDS
Phone: 682-225-3196